Outstanding Alumni Awards Nomination

Outstanding Alumni Awards Nomination

Please submit your suggestions for 2018

NOMINEE INFORMATION

* Required information. To ensure your nominee receives maximum consideration, please fill in the form as completely as possible. If you have questions or would like a hard copy of the nomination form, please contact Kelsey Hukill at 360.992.2767.

Full Name
*

Address 1

Address 2

City

State

Zipcode

Phone (including area code)
*

Email

Current Employer

Title / Position

Address 1

Address 2

City

State

Zipcode

Years attended Clark College (e.g., 1961 - 1963)

Is nominee a graduate of Clark College?

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NOMINEE'S ACCOMPLISHMENTS AND CONTRIBUTIONS

Has provided exceptional services to the College through activities with the Alumni Association, volunteer work, financial support, or College employment:

Has demonstrated exemplary service to the community:

Has received recognition by community members (i.e., awards, honors):

Has demonstrated personal and/or professional achievements:

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NOMINATOR'S INFORMATION

Full Name
*

Phone (including area code)
*

Email
*

Relationship to Nominee
*

Please provide the names of two additional individuals who are familiar with the candidate and would endorse this nomination

Full Name
*

Phone (including area code)
*

Email
*

Full Name
*

Phone (including area code)
*

* Required information. To ensure your nominee receives maximum consideration, please fill-in form as completely as possible. If you have questions or would like a hard copy of the nomination form, please contact Vivian Cheadle Manning at 360.992.2104 or vmanning@clark.edu.